乌司他丁联合持续血液净化对ARDS患者呼吸功能及血流动力学的影响.doc

乌司他丁联合持续血液净化对ARDS患者呼吸功能及血流动力学的影响
[摘要] 目的 探討乌司他丁联合持续血液净化对ARDS患者呼吸功能及血流动力学的影响。 方法 选择我院2016年2月~2017年2月收治的88例ARDS患者,随er treatment, CL level increased and Raw and PIP level decreased in both groups. After 3 and 7 days of treatment, compared with those before treatment, the differences were statistically significant(P<). After treatment, CL level increased and Raw and PIP level decreased in both groups. After 3 and 7 days of treatment, they were compared with those before treatment, the differences were statistically significant(P<). There was no significant difference in the levels of CL, Raw and PIP between the two groups before treatment and 1 day and 7 days after treatment. After 3 days of treatment, the levels of CL, Raw and PIP were significantly different between the two groups(P<). After treatment, HR, MAP, PCWP, CI and other hemodynamic indicators were significantly improved in both groups(P<), but there was no significant difference between the two groups(P>). The duration of mechanical ventilation, APACHE-Ⅱ score, ICU ward time and mortality in the treatment group were lower than those in the control group(P<). Conclusion Ulinastatin combined with CBP can effectively improve the arterial blood gas index, respiratory function and hemodynamics of ARDS patients, reduce the duration of mechanical ventilation, ICU ward time and reduce the mortality rate of patients. The curative effect is satisfactory, and it is worth popularizing and applying. [Key words] Ulinastatin; CBP; ARDS; Respiratory function; Hemodynamics
多数观点认为急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)是由各种原发性炎症及感染等多种因素引发肺损伤,导致患者呼吸衰竭、动脉高压及低氧血症等的发生,而机体炎症反应失控是ARDS的主要诱发因素[1]。ARDS是一类临床常见危重急症,其病情凶险且死亡率达40%以上[2]。目前对于ARDS治疗较为有效的方法是持续血液净化(continuous blood purification,CBP)治疗。CBP通过清除患者机体炎性介质、阻断炎症反应,能够有效的改善患者呼吸功能及血流动力学[3]。乌司他丁作为一种蛋白酶抑制剂,具有抑制炎性因子的作用,近年在临床急性循环衰竭的抢救中已得到越来越多的应用。本研究通过应用乌司他丁联合CBP治疗ARDS患者,探讨其对ARDS患者呼吸功能及血流动力学的影响,现报道如下。
1 资料与方法
一般资料
选择我院急诊科2016年